Dry Gangrene With Ischemic Necrosis Of The Skin

Dry gangrene in a female patient with type 2 diabetes, involving the distal parts of the toes of her right foot is illustrated in Figure 7.2. The pedal arteries were not palpable and the ankle brachial index was 0.4. A well-demarcated red area extended up to the ankle and the lateral foot, indicating ischemic necrosis of the skin. Angiogra-phy showed the patient to have multilevel severe atherosclerotic disease with involvement of the tibial and pedal arteries. An attempt at mid-tarsal (at Lisfranc's joint) disarticulation was unsuccessful, as it was discovered during the operation that the deep tissues were all necrotic. Finally, the patient sustained a below-knee amputation.

Keywords: Dry gangrene

Figure 7.2 Dry gangrene of the distal areas of the toes of the right foot. The well-demarcated red area extending up to the ankle and the lateral foot indicates ischemic necrosis of the skin. (Courtesy of E. Bastounis)

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